4. While a 67-year-old female is shopping for groceries, she faints and falls. S

Question

4. While a 67-year-old female is shopping for groceries, she faints and falls. She is driven home by a friend. When home, she realizes that she is bleeding from her mouth and is slightly disoriented. She appears injured from the fall, but she does not remember tripping or falling. The woman is taken to a local emergency department. The examining physician determines that there was a loss of consciousness; to determine the reason, he orders a head CT and ECG and the following laboratory tests: CBC, PT, allL, CK, LDH, AST, and troponin T and troponin I. All tests are within normal limits. The woman is sutured for the mouth injuries and admitted to a 24-hour observation unit a. What possible diagnoses is the physician considering? b. What laboratory tests would be elevated at 6, 12, and 24 hour if this patient had an AMI! c. What isoenzyme tests would be useful with this patient?

Explanation / Answer

Activated partial thromboplastin time (aPTT) test for detecting blood coagulation.

Prothrombin time (PT) test is used for measuring how long it takes blood to clot.

Aspartate aminotransferase (AST) test for detecting liver damage

Troponin levels for detecting heart attack.

So the possible diagnosis may be: heart attack, liver disease, or blood coagulation diease.

Troponin levels can be detected in 6, 12 and 24 hr for diagnosing AMI.

Creatine kinase isozymes test can be useful for this patient for confirming AMI.

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